. Laparoscopic Colectomy Cooper M, et al., BMJ 2014.

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Presentation transcript:

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Laparoscopic Colectomy Cooper M, et al., BMJ 2014.

Laparoscopy Rate by Surgeon % Colectomy Operations Performed Laparoscopically

210,000 deaths

Causes of Death in the U.S. Heart disease 597,689 Cancer 574,743 Variation 210,000 - 400,000 Respiratory diseases 138,080 Makary MA, Daniel M. Medical Error: The third leading cause of death in the U.S., Johns Hopkins University, 2015

Individual Responsibilities A Model for Reducing Patient Harm System Responsibilities Individual Responsibilities 1 Institute safety triggers to alert staff Facilitate a culture of speaking up Knowledge of Remedies Skill to intercept harm Make errors more visible Make remedies available Support clinician needs 2 Clinical skill Sound judgment Respond to error (Rescue) Error awareness Calling for help 3 Foster a culture of safety Engineer hard stops for prevention Make errors less frequent Source: Makary M, Daniel M Medical Error-The third leading cause of death in the U.S.. BMJ 2016

What percent of Medical Care is Unnecessary? % Respondents Lyu H et al, Unpublished data, Johns Hopkins University School of Medicine

Xu T, et al. AGA 2015

Proportion of Medical Care that is Unnecessary National Survey of 2,106 Physicians Lyu H, Xu T, Brotman D, Mayer-Blackwell B, Cooper M, et al. (2017) Overtreatment in the United States. PLOS ONE 12(9) http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0181970

22% of prescription medications 25% of medical tests 11% of procedures Proportion of Medical Care that is Unnecessary National Survey of 2,106 Physicians 22% of prescription medications 25% of medical tests 11% of procedures 20% OF ALL MEDICAL CARE Lyu H, Xu T, Brotman D, Mayer-Blackwell B, Cooper M, et al. (2017) Overtreatment in the United States. PLOS ONE 12(9) http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0181970

$20 Obamacare FUTURE Hospital (ICU, ER and OR only) OPTIMIST

Thank You Facebook.com/DrMartyMakary Twitter: @DrMartyMD Email: martymakary@gmail.com